The number of Māori academic staff remains disproportionately low at New Zealand universities. Simon Day spoke to three newly appointed Māori professors at the University of Otago about why putting te ao Māori at the centre of their work is so important.
Māori participation in tertiary education is steadily increasing. According to the Ministry of Education, the number of Māori students enrolled in university study increased by 19% from 2008 to 2018, and now represents around 12% of all local university students. That’s still below the 16.5% of the population who are Māori.
Despite this growth, research released last year shows that the number of Māori academics at New Zealand’s universities remains persistently low. According to the research paper ‘Why isn’t my professor Māori?’, Māori academics make up around 5% of the workforce across the eight universities and this number has stagnated.
The researchers emphasised how important it is for Māori students’ success to see themselves reflected in their teachers at university. But it is also essential for non-Māori students to see New Zealand’s indigenous people as experts and their views as valuable as those that have traditionally dominated academic spaces.
At the end of 2019, three Māori staff were appointed to the position of professor at the University of Otago. Professor Joanne Baxter (Poutini Ngāi Tahu, Ngāti Apa ki te Rā Tō) has worked to increase the recruitment, retention and achievement of Māori students in health sciences and health professional programmes. Professor Suzanne Pitama’s (Ngāti Kahungunu, Ngāti Whare) work addresses Māori health inequities through medical education and health research. And Professor Miles Lamare, associate dean Māori for the Division of Sciences, has overseen the department as it increased its partnerships with local Māori in the way it manages coastal ecosystems.
Their appointments represent an essential opportunity for Māori students at the University of Otago to see Māori success in fields where they’re underrepresented and underserved. Their positions as professors provide inspiration for Māori students and validation for the role of kaupapa Māori in their fields.
For a long time, the number of Māori doctors in the workforce has hovered around 3%. At the same time, Māori health remains conspicuously poorer than other New Zealanders. The catalogue of health inequities is long: on average, Māori life expectancy is six years shorter than non-Māori, and Māori are more than twice as likely to die from cardiovascular disease, twice as likely to have diabetes, and have significantly greater rates of cancer.
Ten years ago, when Professor Joanne Baxter became associate dean Māori at the University of Otago’s School of Medicine, she could see the different inequities for Māori cycling around each other in the health system. It was clear to her that inequalities in education were leading to inequalities in the health workforce, inequalities in the health workforce were leading to poor health outcomes, and poor health outcomes were leading to poor education.
In 2010, the University of Otago established the Māori Health Workforce Development Unit (MHWDU) with Baxter as its director. The unit was designed to inspire Māori into health professional courses and guide those students through their study and into the workforce.
“We’re supporting the whole pathway,” says Baxter. “Once they’re in degrees, we make sure they’re successful in them. And then we make sure they’re successful in work. In that time we’ve seen a dramatic increase in Māori coming to health professional programmes and graduating from them.”
Since the introduction of the MHWDU, the medical school has had significant success in attracting Māori students and guiding them through the course. In 2020, Māori represent 20% of the new intake into a Bachelor of Medicine.
The initial impact of the MHWDU on the workforce began in 2016 when the first MHWDU assisted students completed their medical training. That year, 46 Māori doctors graduated from the University of Otago medical school.
“That was a big increase. It increased the Māori medical population by almost 10%. There are 15,000-16,000 doctors and only 500-600 are Māori,” says Baxter.
“We’re trying to do that across dentistry and physio and the other programmes as well. It’s going to take a really long time to bend the workforce statistics. We’ve got a long way to go to fully change the face of the workforce.”
When Professor Suzanne Pitama studied as an educational psychologist, the curriculum she was taught positioned Māori having a key role in their inequitable health outcomes. Narratives such as laziness, lack of compliance, deficiencies in cultural connectedness and poor behaviours were commonly portrayed through lectures. Throughout her entire seven years of training she had just two hours of class dedicated to Māori health, each of these steeped in stereotypes and deficit framing of Māori.
Pitama’s focus at the Māori/Indigenous Health Institute (MIHI) has been to develop a Māori health curriculum that positions the impacts of the determinants of health – colonisation, racism, marginalisation – as the context to Māori health inequities.
“My role is to develop graduates that will support Māori health gains,” she says. “Our team wanted to create a Māori curriculum that was designed from a te ao Māori lens and narrative, that was strength-based, and had the ability to critique institutional racism and magnify the impacts of colonisation.”
“There was a need to design a curriculum that addressed the true cause of Māori health inequities like colonisation. This includes clearly presenting New Zealand history, to describe how colonial processes removed resources (wealth) and plunged Māori into poverty.”
Pitama and her team developed the Hui Process and Meihana Model as ways to provide health professionals and students with a framework in which to apply a decolonised approach to their clinical practice. These models are now a key component of the Māori health curriculum at the Otago Medical School and are being adopted by medical colleges and other health professional bodies.
Then came the challenge on how to teach Māori health when traditional medical and clinical teaching is ward-based or based within specific health settings. This led to an emergence of innovative ideas such as paediatric screening within Kura Kaupapa Māori and the use of simulated patients. All learning approaches are embedded in Māori approaches to learning and engagement.
Students know how to comfortably ask questions about the impact of colonisation and racism, and have a better understanding of how the health system maintains current inequities. This has empowered the University of Otago’s medical students to connect with Māori patients in a way previous generations of doctors weren’t equipped to.
“As we’ve evaluated our programme by interviewing patients who have been interviewed by our students, for many, their interview with a medical student was their first positive experience in the health system” she says.
“It’s changing the way the students take a patient’s history and the way they consider symptoms and allow them to provide better diagnosis for Māori patients.”
Pitama recalls a case two years ago when a final year med student interviewed a Māori patient. She was presenting with a really sore back and it was her third presentation. The student used a model designed by the MIHI team to take a full family history. They noted a cough and got a full history of the cough, and became concerned something was being overlooked. Her concerns were initially dismissed by her superiors, but she persisted with the staff on the next shift who agreed it was worth an x-ray.
The x-ray revealed lung cancer. It was caught in its early stages and removed, and now the patient is in early remission.
“Those stories keep me excited about my mahi. There are so many stories like this one, where we have our students or our graduate doctors, who know how to get a more holistic and complete history from our Māori patients. This approach changes how they consider diagnosis and treatment. It’s improving health experiences for patients, whānau and clinicians, and is saving lives,” she says.
Professor Miles Lamare grew up far from his marae, migrating between Pacific Islands for his father’s work. But he was always aware of his whakapapa. As a young boy he was always connected to the ocean and in the first week at university he saw a marine science programme and knew that was his future. The traditional relationship Māori have with the ocean made Lamare more aware of his environment and his role as its kaitiaki.
First, as a department kaiāwhina, then as the associate dean Māori for the Division of Sciences, Lamare had the opportunity to explore his taha Māori through his academic career. His promotion makes him the first Māori marine biologist professor at the University of Otago. He recognises that Māori are New Zealand’s first and most experienced marine biologists and that indigenous knowledge has become an important part of the division’s teaching.
Kaupapa Māori has become an increasingly recognised part of the way science is taught. Lamare has watched students embrace indigenous knowledge and practices of marine biology in the protection and management of New Zealand’s coastline. He points to the work of his colleague Chris Hepburn who has collaborated closely with Kāi Tahu and Puketeraki marae north of Dunedin. The students work closely with local communities to share knowledge about how to look after their resources and ecosystems.
“We take students out there and they will work with local iwi. It’s a mix of contemporary and Vision Mātauranga on how you would manage an ecosystem. The students love that.”
Lamare is committed to attracting more Māori students to the sciences. He’s travelled around New Zealand as part of science wānanga run with local Māori communities. A group of academics visit and teach on local marae with groups of Māori high school students. It’s a front line initiative to ensure more Māori enter the sciences.
As kaiāwhina, Lamare’s work was to ensure Māori students succeeded at the university once they were in the pipeline. “We’d encourage Māori students. We’d engage with them. We’d ensure they were keeping on track,” he says.
Now as a professor, he’s proud of the opportunity he’s been given to show prospective Māori scientists that this is a pathway they can succeed in.
“Universities are one place that have not always been seen as somewhere that a young Māori scientist or academic can carry on in an academic career. But you need people succeeding at those levels that allow others to know they have a place here. You can actually inspire the next generation down,” he says.
But there’s still a long way to go for Māori academic leadership to be representative of the population. Because the higher you look in an academic institutions’ leadership hierarchy, the harder it is to find Māori representation.
Baxter describes herself as a “public health medicine specialist who just happens to work at a university.“ She also knows the success she’s had within the public health system has happened because of the opportunities to influence that system from its core.
“Becoming a professor is a great career outcome, but it’s not as important for me as what it means for making an impact for Māori health outcomes. I do what I do – the teaching and research – because it gets really amazing outcomes for Māori health,” she says.
Baxter is proud of the progress the MHWDU has achieved for Māori health. But she knows that for those results to continue, further systemic recasting has to happen at the university. More value needs to be placed in Māori expertise and this needs to happen in the areas where staff shortages are their worst, fields like chemistry, anatomy and physics.
“I think it is crucial and I think we’ve got a way to go. We have a long way to go for our staff growth to reflect our student growth.”
This content was created in paid partnership with the University of Otago. Learn more about our partnerships here.
Subscribe to The Bulletin to get all the day’s key news stories in five minutes – delivered every weekday at 7.30am.